Current endovascular treatment options for intracranial carotid artery atherosclerosis

2005 ◽  
Vol 18 (1) ◽  
pp. 1-4
Author(s):  
Ricardo J. Komotar ◽  
J Mocco ◽  
David A. Wilson ◽  
E. Sander Connolly ◽  
Sean D. Lavine ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Stent Placement ◽  
Multidisciplinary Approach ◽  
Internal Carotid ◽  
Treatment Options ◽  
Intracranial Atherosclerosis ◽  
Carotid Artery Atherosclerosis ◽  
Endovascular Methods

A substantial number of strokes are caused by intracranial atherosclerosis, a disease that traditionally has been treated medically. Recent technological advancements, however, have revolutionized the treatment of this condition by enabling the use of endovascular methods. In this paper the authors focus on the internal carotid artery, and review relevant studies concerning angioplasty with stent placement for the management of intracranial atherosclerosis in this vessel. With continued experience and a multidisciplinary approach in the evaluation of these patients, favorable outcomes may be achieved.

Reconstructive endovascular treatment of ruptured blood blister–like aneurysms of the internal carotid artery

2009 ◽  
Vol 110 (3) ◽  
pp. 431-436 ◽  
Author(s):  
Byung-Hee Lee ◽  
Byung Moon Kim ◽  
Moon Sun Park ◽  
Sung Il Park ◽  
Eun Chul Chung ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Scale Score ◽  
Stent Placement ◽  
Glasgow Outcome Scale ◽  
Internal Carotid ◽  
Covered Stent ◽  
Stent Insertion ◽  
Endovascular Methods

Object Ruptured blood blister–like aneurysms (BBAs) of the internal carotid artery (ICA) are rare but carry a high rate of morbidity and mortality. Furthermore, BBAs are very difficult to treat surgically as well as endovascularly. The authors present their experience in treating BBAs with reconstructive endovascular methods. Methods Nine ruptured BBAs in 9 consecutive patients (2 men and 7 women; mean age 50 years, range 42–57 years) were treated using reconstructive endovascular methods between January 2006 and November 2007. Treatment methods and angiographic and clinical outcomes were retrospectively evaluated. Results All 9 BBAs were initially treated with stent-assisted coil (SAC) embolization. This was followed by a second stent insertion using the stent-within-a-stent (SWS) technique in 3, covered stent placement in 3, and SAC embolization alone in 3. All 3 patients who underwent SWS placement had excellent outcomes (Glasgow Outcome Scale Score 5) with complete angiographic resolution of the BBAs. There were no treatment-related complications in the SWS group. Two of the 3 patients who received covered stents had excellent outcomes (Glasgow Outcome Scale Score 5) and complete occlusion of the BBA was achieved. The remaining patient who received a covered stent died of ICA rupture during the procedure. Aneurysm regrowth without rebleeding occurred in the 3 patients who underwent SAC embolization. Two of the 3 recurrent BBAs were treated with coil embolization with a second stent insertion, and as a result these belonged to the SWS group. The other recurrent BBA was treated with a covered stent. Of the 8 surviving patients, 5 underwent SWS, and 3 underwent covered stent placement. All surviving patients had excellent outcomes during the clinical follow-up period (mean 11 months, range 4–26 months); complete BBA resolution and smooth reconstruction of the affected ICA segment was shown on follow-up angiography. Conclusions In the present study, the SWS and covered-stent techniques effectively prevented rebleeding and regrowth of the BBA without sacrifice of the ICA. The SWS and covered-stent techniques can be considered an alternative treatment option for BBAs in selected patients in whom ICA sacrifice is not feasible. Stent-assisted coiling alone seems insufficient to prevent BBA regrowth.

scholarly journals Komplex nyaki és agyi érpatológia endovascularis kezelése

2017 ◽  
Vol 158 (18) ◽  
pp. 706-710
Author(s):  
Csaba Oláh ◽  
Máté Czabajszki ◽  
István Lázár
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Internal Carotid ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Current Treatment ◽  
Internal Carotid Artery Stenosis ◽  
Glomus Jugulare ◽  
Present Complex

Abstract: Authors present complex multistage endovascular treatment of female patient with an intradural infiltrative, inoperable tumor of the glomus jugulare, a stenosis of the internal carotid artery and an aneurysm of middle cerebri artery. In the literature our case report is the first announcement in which three pathology coexist ipsilateral in one patient and the patient has been treated step by step by endovascular procedures. Beside the endovascular treatment steps they display glomus jugulare tumor’s symptoms, staging, treatment options and also the current treatment guidelines of internal carotid artery stenosis and intracranial aneurysms. Orv Hetil. 2017; 158(18): 706–710.

scholarly journals Endovascular Treatment of Extracranial Internal Carotid Pseudoaneurysm: Description of Three Cases

2016 ◽  
Vol 02 (02) ◽  
pp. e15-e18 ◽  
Author(s):  
Andrea Giorgianni ◽  
Carlo Pellegrino ◽  
Camilla Micieli ◽  
Anna Mercuri ◽  
Renzo Minotto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Surgical Approach ◽  
Stent Placement ◽  
Internal Carotid ◽  
Carotid Dissection ◽  
Endovascular Stent ◽  
Artery Pseudoaneurysm ◽  
Endovascular Stent Placement

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA). These lesions are difficult to treat with a surgical approach, especially if they are located extracranially and close to the skull base. Endovascular stent placement in symptomatic and unstable extracranial internal carotid PSA was found to be safe and effective. Depending on hemodynamic aspects, complete local exclusion of aneurysmal formation is achieved in few months. We present three patients with carotid dissection and PSA formation that have been successfully treated by stent placement.

Reconstruction of the Internal Carotid Artery After Treatment of Complex Traumatic Direct Carotid-Cavernous Fistulas With the Willis Covered Stent

Neurosurgery ◽  
2016 ◽  
Vol 79 (6) ◽  
pp. 794-805 ◽  
Author(s):  
Wu Wang ◽  
Ming-Hua Li ◽  
Yong-Dong Li ◽  
Bin-Xian Gu ◽  
Hai-Tao Lu
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Stent Placement ◽  
Internal Carotid ◽  
Covered Stent ◽  
Covered Stents ◽  
Complete Exclusion ◽  
Carotid Cavernous Fistulas

Abstract BACKGROUND: Endovascular treatment of complex traumatic direct carotid-cavernous fistulas (TDCCFs) is a challenge. OBJECTIVE: To evaluate the long-term efficacy of the Willis covered stent in endovascular treatment of complex TDCCFs, focusing on reconstruction and preservation of the internal carotid artery. METHODS: During the past 8 years, 25 patients with 27 TDCCFs who previously had unsuccessful treatment of fistulas with detachable balloons received endovascular treatment with Willis covered stents. The efficacy, complications, in-stent stenosis, angiographic, and clinical follow-up results were evaluated retrospectively between 6 and 88 months (mean, 43.8 months) after the stent placement. RESULTS: The technical success rate of stenting placement was 100%. Forty-four Willis covered stents were implanted into the target artery of 27 TDCCFs. Complete exclusion was achieved in 16 patients with 17 TDCCFs immediately after the stent placement, with transient endoleaks in 10 TDCCFs. Redilation was performed in 6 TDCCFs, and additional stents were implanted in the other 4 TDCCFs for endoleak exclusion. The initial angiographic results showed complete exclusion of fistulas with preservation of the internal carotid artery in 24 patients with 26 TDCCFs. One patient in whom complete occlusion initially was achieved subsequently experienced a delayed endoleak, which required placement of an additional stent. The angiographic follow-up results (mean, 30.3 months) demonstrated complete exclusion in all 27 TDCCFs, with patency of internal carotid artery in 23 patients. The clinical follow-up demonstrated a full recovery in 23 patients and improvement in 2 patients. CONCLUSION: The use of Willis covered stents was confirmed to be effective, safe, and a curative approach for endovascular treatment of complex TDCCFs and internal carotid artery reconstruction.

scholarly journals Internal Carotid Artery Injury in Transsphenoidal Surgery: Tenets for Its Avoidance and Refit—A Clinical Study

2021 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Dmitry Usachev ◽  
Oleg Sharipov ◽  
Ashraf Abdali ◽  
Sergei Yakovlev ◽  
Vasiliy Lukshin ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Transsphenoidal Surgery ◽  
Internal Carotid ◽  
Treatment Options ◽  
Carotid Artery Injury ◽  
Anatomical Features ◽  
Stent Grafting ◽  
Internal Carotid Artery Injury

One of the most serious/potentially fatal complications of transsphenoidal surgery (TSS) is internal carotid artery (ICA) injury. Of 6230 patients who underwent TSS, ICA injury occurred in 8 (0.12%). The etiology, possible treatment options, and avoidance of ICA injury were analyzed. ICA injury occurred at two different stages: (1) during the exposure of the sella floor and dural incision over the sella and cavernous sinus and (2) during the resection of the cavernous sinus extension of the tumor. The angiographic collateral blood supply was categorized as good, sufficient, and nonsufficient to help with the decision making for repairing the injury. ICA occlusion with a balloon was performed at the injury site in two cases, microcoils in two patients, microcoils plus a single barrel extra-intracranial high-flow bypass in one case, stent grafting in one case, and no intervention in two cases. The risk of ICA injury diminishes with better preoperative preparation, intraoperative navigation, and ultrasound dopplerography. Reconstructive surgery for closing the defect and restoring the blood flow to the artery should be assessed depending on the site of the injury and the anatomical features of the ICA.

scholarly journals Indications and Problems of Intracranial Stenting Report of Two Cases

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 149-154
Author(s):  
J. Deguchi ◽  
T. Kuroiwa ◽  
S. Nagasawa ◽  
G. Satoh ◽  
T. Ohta
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
External Force ◽  
Stent Placement ◽  
Internal Carotid ◽  
Total Occlusion ◽  
Intracranial Stenting ◽  
Linear Portion ◽  
Vertebrobasilar Artery ◽  
Intracranial Arteries

There have been few reports of stenting in the intracranial arteries. We used coronary stents in the chronically occluded intracranial vertebral artery and stenosis of internal carotid artery by the external force, and good blood flow were resumed. Stenosis in the intracranial arteries is also a good indication for stent placement when it is due to chronic total occlusion or artery compression by external force. But stent placement in the intracranial arteries has some problems. Stent placement in the intracranial artery is indicated only when the site of stent placement has a diameter of 3 mm or more, is a relatively linear portion of the vertebrobasilar artery or the internal carotid artery proximal to the C3 segment, and does not branch off perforating arteries or is already completely occluded.

scholarly journals Ruptured Petrous Carotid Pseudoaneurysm Due to Tuberculous Otitis: Endovascular Treatment

2006 ◽  
Vol 12 (1) ◽  
pp. 53-56 ◽  
Author(s):  
A.B. Yagci ◽  
F.N. Ardiç ◽  
I. Oran ◽  
F. Bir ◽  
N. Karabulut
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Unusual Case ◽  
Internal Carotid ◽  
Surgical Intervention ◽  
Imaging Findings ◽  
Parent Vessel ◽  
Detachable Balloon ◽  
Artery Pseudoaneurysm

We report the imaging findings and endovascular treatment in an unusual case of petrous internal carotid artery pseudoaneurysm due to primary tuberculous otitis. The aneurysm was recognized and ruptured during a surgical intervention for otitis. Successful endovascular treatment of the aneurysm was performed by occlusion of the parent vessel using detachable balloon and coils.

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